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if you look online, many people are having problems with this generic version because of it's time release. it releases more of the product in the beginning of the day as opposed to small amounts throughout the entire day. this leaves you hanging towards the end of the day, leaving you feeling like **it. most of the people i know who have had this problem have since switched back to brand and have not had a repeat of the problems.

In short, taking half your medication is not as effective as a full dose and may not properly treat whatever it is your taking the medication for.

And as for just physically splitting the tablets, time-release tablets are specifically engineered to not be split, so splitting them defeats the entire purpose of the time release medication.

Some of these are just plain common sense. But at the same time, it's not like I could have prevented myself from becoming mentally ill.

Of course, my sister went in to get a prescription, and she ended up on a 5 dollar generic...so I guess it's all in who you see.

Writing a 90 day script for 30 days is pretty fishy to me. Especially with the street value of Adderall :)

I did not state that. I stated there was a greater variation to the actual dose be it above or below.

I would also add, to beef up the "try natural remedies" tip, to consider consulting a naturopath or herbalist, especially if your problem is managing a symptom or a non-life-threatening condition. They're usually cheaper, and often have suggestions for diet, lifestyle, and natural remedies that can let you avoid drugs altogether. I can't even BEGIN to enumerate the money, side-effects and hassle I've saved that way!

@ice2032: I've never been hurt by splitting a table....Oh! Tablets! I think the article was probably assuming that the reader had a third-grade grasp of math...you know, 1/2 of 100mg is 50mg? And not to stretch your logic-gland, but there's nothing wrong with advising a population that overall takes way too many drugs to take less!

and telling people to split tablets? is this guy a doctor? does he know whats going to happen when people only take half of their heart medication? this was the worst article ive read on here in a long time, and while most of the blame should be put on the guy who wrote the piece of trash, consumerist should never have posted it in the first place.

In my earlier post, I forgot one of the best resources I've found for reducing my prescription drug costs: just telling my doctor about my financial situation and what I spend on drugs each month. I filled a ($125) scrip another doctor in the practice wrote without looking closely enough at my history (I don't blame him -- it was an emergency situation and he was doing his best to see me between other appointments), then learned it was contraindicated for people with nut allergy. When I followed up with my regular doctor, I mentioned it to him, saying I wouldn't complain but I already spend about $300/month on prescriptions, he kind of blanched, reviewed my history and found cheaper medications wouldn't really work, and sent me home with a shopping bag full of free samples instead.

I guess this is similar to the "insist on generics", etc. suggestions above, but less combative.

It is worth it to ask your doctor about new studies (hell, I was willing to offer myself as a guinea pig), but I'd avoid BRAND! NEW! DRUG! stuff that involves a not-doctor rowing a canoe.

"Why was this script only filled every 3 months?"

Answer..1) I keep forgetting to take my medication and I generally get it filled about every 3 months which is when I run out?

2) You mean I'm not supposed to take 1 a day? I'm supposed to take 3 a day? I didn't know that.

They won't take the customer to court over it. Pharmacy, they will lose their reimbursement for it if it can be proven. Physician, maybe look into him.

@t0fu: DEA does not get involved into physicians unless their is a controlled substance issue, and that usually has to be a schedule-II drug. Generally the local state agency regulates all scripts regarding schedules 3-5. Non controls are also regulated by the state agencies and insurance companies generally.

-Phex
-3rd Year PharmD / MBA Candidate

I will try them, but I have limited patience. (I'm on anti depressants, anti anxiety and birth control. I need all three to work, thanks. I'm on generic on two out of three.)

In my area, Meijer has some medications for FREE, which beats Wal-Mart's and Target's (otherwise good) multi-month deals hands down. I picked up an antibiotic once using this, and needed nothing but my scrip.

If you are leaving health insurance (to go back to school, for example) ask you doc for a travel prescription. I was able to get 90 days of *all* meds doing this, which was enough to tide me over.

@ninabi:

Check the bottle. Many brand name drugs are made in the same places as the generics (China, India, sout east Asia). Just becasue they are brand doesn't mean they are made in the USA

@t0fu:

The DEA couldn't care less about how a Dr. is writing unless they are doing funny things with Control Substances. The practice would be delt with on the state level with the body the regulates Dr. licenses to practice

Medicine's constantly evolving. Sometimes good, sometimes bad. When I read Sir William Ossler's writings and texts, some of the theories and treatments are laughable if not flat-out scary. At the same time, I've found a few times when his ideas were quite insightful and useful, quite particularly when modern medicine fails to produce satisfactory answers.

@Jesse in Japan: I'm fully aware of that, but that doesn't make up for the remaining 40% of the scripts written.

If caught they could lose their license with the DEA.

I'm suprised that noone has mentioned this but having your Dr. write a 3 month supply as a 1 month supply (ie 1 tab 3 times a day but you really only take 1 a day) is insurance fraud as clear as it gets. But all Consumerist readers like sticking it to the corps so I'm sure you are all over it. Just don't get caught by an insurance audit. They do check adn may notice that you are refilling your monthly drug only every 3 months. Then they will come looking for their money from you. You are screwing them out of 2/3 of their copays.

The generics can be off as much as 25% as what they are supposed to be. (ie 100mg could end up being 75-125mg)

This is especially important to know if you are on Bipolar/schizophrenia medication like lamictal or ambilify. Your body knows the difference between just a few milligrams.

Point being, if exact dosing is needed- push for the name brand, they're more expensive but your body will thank you.

1. Never take a researcher's "preliminary results" too seriously. See: 'Cell phones cause cancer'
2. Never take the first study too seriously.
3. Never take anything you see on TV too seriously.
4. Never take anything that isn't peer reviewed seriously.
5. Never take anything reported in an alternative medicine publication seriously if that publication is owned by, or shills for a dietary supplement manufacturer. Frankly, the only way all those magazines at the checkout at Whole Foods stay in business is by promulgating the idea that the medical establishment is inferior to the natural healing industry. Medicine ain't perfect, of course, but at least there's _some_ oversight.
6. Always take any study other than a double-blind controlled study with a grain of salt. Epidemiology is tricky.
7. Make friends with a doctor or nurse who isn't your own doctor so you can get a quick reality check on the treatment you're receiving. Your doctor may be just as susceptible to media hype as anyone else and may be getting all her info from a drug company rep.
8. Be a little wary of any doctor with an office full of pens and pencils and posters and t-shirts and mugs plastered with a drug company's name. Caveat: a lot of good docs keep this stuff around and use drug company reps to get free samples.
9. Be very, very suspicious of any claim that in any way benefit the person making the claim. Benefits include notoriety, drug sales, increased readership, etc.

There have been very few times in the history of medicine when acting immediately on a new piece of research saved lives. There have been many times when acting on a new piece of research made someone _a lot_ of money. Wait for the second study. As with Apple products, early adopters are usually punished by the gods.

When I started on "the pill", my ob/gyn prescribed a new pill that cost $40/month with insurance. When I found out at the pharmacy how much it cost, I took the prescription back and told them "the pill" had been out for more than a few years, and I was sure that there was a more reasonably priced version in the same group and demanded that. Those pills were out for about 20 years and were only $6 on copay. You can't tell me that docs weren't getting some sort of kickback for prescribing the first pill. I also let them know that since I could no longer trust them to give me a reliable pill at a reasonable price on the first try, I could no longer in good faith trust them for any other services. But then who do you trust?

-- The great majority of Part D plans restrict MTM services to a specific subgroup of their covered entities. Most Part D patients are not eligible for MTM services with their local pharmacist.

As far as generics go, all AB rated generics, by definition, have the same bioavailability as the brand name product. Other factors, such as release rate may be different, but the dose of the active ingredient that is expected to be absorbed and made available to the body should be the same. Oh, and some generics are the brand name product. When Lotrel first went generic the generic bottles were filled with the brand name capsules... right down to the LOTREL stamp on the cap. Same with the new Ocella generic for Yasmin, its the brand name tablets in a different package.

I have a problem with the suggestion to comparison shop because what most people end up doing is getting prescriptions filled at multiple pharmacies. This is a bad thing because no single pharmacy will, in all likelihood, have your full drug profile. As an example, a patient of mine who was on amiodarone (unknown to us) was given a prescription for erythromyin. According to our profile that was a fine antibiotic to use but his insurance company rejected the claim due to an interaction with the amiodarone which could have been potentially deadly. Considering most people can't even remember how many medications they take, let alone the names, this could have been a grave situation without the intervention of the insurance company.

Not that I think considering generics is inappropriate, just adding my voice to those suggesting that these suggestions might be a little oversimplified.

@SkokieGuy: Or the hospitalized diabetic who had the dietician chosen breakfast of Cheerios and pancakes.



@Consumerist-Moderator-Roz: You misspelled y'all. The apostrophe takes the place of the "ou" from "you" in the phrase "you all" to form the contraction.

But I still really don't get the splitting pills suggestion! There's a prescribed dosage for a reason, right?

How else does one explain the popularity of Kevin "con artist" Trudeau's "Natural Cures".

There are many ways for you to become more scientifically literate so that you will be able to perform a critical analysis for yourself.

Check Amazon or your library for "Snake Oil Science" and "Trick or Treatment". Both will help you understand some misconceptions.

"How Doctors Think" is summarized at Wiki.
[en.wikipedia.org]

Also look at these sites: Quackwatch and Skeptic Magazine for info about proper evaluation

When you can answer "why "proof" is not a word used in scientific methodology" and "why the term "significant" (when used to report a study's results)doesn't mean "important", then you'll be on your way to being better prepared.
Best regards

ELIMINATE NONESSENTIAL PRESCRIPTIONS
All my medications are needed and will continue to be needed for the rest of my life

THINK OUTSIDE THE PRESCRIPTION DRUG BOTTLE
5. Treat with lifestyle changes
6. Use nondrug treatments
7. Prevent disease naturally

Explain how I can treat cancer and the sequelae of no thyroid and no parathyroids with "lifestyle changes" or prevent a number of genetic traits "naturally". If it recurs I don't need healing enemas and low-gluten organic pasta. I need radiation, surgery and maybe light chemo along with synthetic hormones and a metric buttload of calcium that I can't get from eating a few more leafy greens. Some herbal remedies work. But that is because they are powerful drugs. What's more, they're powerful drugs with no dosage control or calibration. And "natural" can be much more invasive and damaging than "artificial".

STEER CLEAR OF OVERPRICED REDUNDANT DRUGS
8. Don't "Ask Your Doctor" (for Advertised Drugs)
9. Insist on generic drugs
10. Insist on cheaper medicines with the same class
11. Insist on a cheaper class from the same treatment goal

These ones are about half good. But not all drugs in the same class or all drugs in the same treatment goal are the same. Angiotensin 1 inhibitors are not the same as Angiotensin 2 inhibitors even though they both lower blood pressure. When you get into more subtle compounds like psychiatric medications the results can be dramatically different within the same class. And some drugs simply have no generic versions.

PLAY IT SMART!
12. Cut costs by splitting tablets
13. Don't treat side effects of one drug with another
14. Comparison-shop

#12 is really stupid as in potentially fatally stupid. Time release drugs must never EVER be split.

#13 is even dumber. Side effects can be debilitating or dangerous. But if there is no alternative to using the drug, there is no alternative to using another to treat the effects. Would you suggest that chemo patients waste away and frickin' DIE because they use anti-nausea drugs or take hemp to give them some appetite?

As if it were just the price of drugs.
My Rx, which I use every day:
1. What's the cause of your complaint?
Can't sleep? Is it caffeine, alcohol, poor diurnal, getting up to pee, posting on Consumerist @ 3AM, side affects of your AllegraD @ 9PM, etc? Try to find the cause.
Occasional nighttime reflux is treated in 5sec by a swig of 15 cents of (Generic) antacid, rather than a daily dose of the "Purple Pill".
2. Numbers are out of whack?
Your Cholesterol/Ratio/Trig is blah,blah,blah.
Your diet sucks, you're too fat, you don't move, etc.
make the Therapeautic Lifestyle Changes (TLC) before a
statin. do some research.
3. Know what drug plan you have & what they cover. Don't
have me write an Rx, then get to the pharmacy only them
call me to say "It's not covered". Check your plan,
I love it when you show up with a copy of your plan
formulary, and I can pick an equivalent. I also keep
a copy of the Walmart $4 list in each exam room. Iff'n
something works just as well, no problema.
4. In a lot of cases, you DON'T need to take the pill every
day. PPIs, arthritis meds, sleep meds, etc. BP, DM,
totally different scenario. My credo: "The minimum
amount of med to get the effect you want". Sometimes
the occasional Aspirin/Tylenol/Motrin/Aleve is better
than a daily Celebrex.
5. Fish oil, Chondroitin/MSM, MVI, Calcium, Flax, Red Rice,
etc., no prob. I may advise to take them, or if you
are taking them, LET ME KNOW. Interactions are a prob,
and yes, I do know about them. Had two patients in the
recent past who did not need BP meds, just needed to
stop eating a half-pound of licorice a day!
6. All of my Pre-certs, Non-formulary requests, Overrides
& form-filling are for naught unless you do the
lifestyle change, know your coverage, do your research,
check your formulary, etc. Don't get grumpy with me
when you just shelled out cash to your Chiro/Herbalist/
Personal Trainer/Pilates Person etc, and I'm a little
too busy caring for patients to stop everything to get
override so you can get brand AmbienCR NOW, when I
already told you to lose fifty pounds, cut down on the
dinner alcohol & after-dinner espresso, try yoga/tai-chi
maybe getting laid.

Patients need to be educated consumers, not whiny brats.

Just my 2cents for now, & most of my patients understand.

Those are great sites, I've rec'd them here too. :) I've gotten all my crazy meds through them at one time or another, and I didn't have to go through an advocate. I just had my doctor sign some forms.

This is a little misleading! They don't mean take less medicine, they mean if you're prescribed 50 mg of something, which costs $30/mo, ask your doc to prescribe you 100 mg, because it's twice the medicine and will probably cost you $32/mo.

3) You don't have to support the devil (Walmart) to save money. Most major pharmacies will match pricing on drugs if asked. The pharmacy I work in even has the Walmart and Kroger lists pinned up to make sure we save our customers as much money as we can. A lot of pharmacists are rated on number of scripts, not company profit, so it is a win/win.

4) This is fairly accurate, but I want to remind everyone to be EXTREMELY cautious when getting sensitive medications through mail order. Coumadin (warfarin), for example, is greatly affected by even 1 missed dose. When a mail order company sends these medications weeks late, it is a hassle and financial strain to maintain therapy. Keep in mind that we pay for convenience every day, and this could be a hidden inconvenience if you didn't already know the risks of mail order.

www.pparx.org

It was a lifesaver for me (grad student with a chronic health condition and no prescription coverage). I didn't need a social worker or doctor advocate for any of the programs for my medications -- I just filled out a simple form to show I was below the low-income guidelines (2x or 3x the federal poverty guidelines usually) for the particular program and sign to attest that I had no prescription coverage.

I do like the suggestions in the post itself, but as people have pointed out, these are not all as easy as they appear. Drugs in the same class aren't exactly equivalent, as I learned when an insurance company refused to cover a new antihistamine I'd done really well on, insisting that an older one "should" work just the same. It didn't, and had the added side effect of inducing massive drowsiness (it's actually also prescribed as a sleep aid). I can only assume the company figured I'd be too itchy, sneezy, and sleepy to fight them on it.

1) Do what pharmfatale said, and go talk to a pharmacist about cutting costs. We are an underutilized resource for information on drugs and drug pricing.
2) Demand generics only from your physician. Generics are just as good as the brand name medications most of the time. Only exceptions are narrow therapeutic index medicines like Synthroid.
3) Shop walmart if you don't have insurance. You should be able to get a list of their covered medications on their 4 dollar list on their website. Try Publix pharmacies for some antibiotics. Kerr Drug, Walgreens, and other pharmacies have plans to help with medications as well.
4) Mail order pharmacy may also be a way to save on money. But do realize that if will be very difficult to speak to a pharmacist at the place that fills your medicines. Not to mention, that sometimes you medicines get lost in the mail and could take weeks to get to you.
5) Exercise more and eat correctly. Hell, just start walking 2-3 days a week for 30 minutes. That will lower your blood pressure some. Preventative care is better in the long run.
6) If you can get your physician to write you a 2-3 month supply in the form of a 1 month supply on the script, more power to you. It will save you copays, but I don't think many physicians will do this.
7) Another option for some medications which is related to #6, is to get double the strength of a medication prescribed to you, and cut the pill in half. The pharmacy will generally do this for you, or you can get a pill splitter and do it yourself. Mind you this is not an option for all medications like extended or delayed release tablets or capsules.
8) Don't go to the physician for every little cold. Try your local pharmacist first. We have the education to tell you if you need to see a physician or if you can be treated with OTC medications or supportive care.

-Phex
-3rd Year PharmD / MBA Candidate

@Bryan Price: I feel for you. My kidney failure resulted in hypertension for me since I was 6 years old. I was on Vasotec (an ACE inhibitor) for a long time before it finally stopped providing any therapeutic benefit. For the past few years, we've been playing "add that drug" and I've been doing the diuretics (HCTZ mostly), beta blockers (Metoprolol, Labetelol), ACE inhibitors (enalapril), and myriad other BP drugs. I WISH I could get off of them because they make me tired and sometimes lightheaded, but I can't. My BP on a good day is around 160/110 and on my worst day, it was 262/212. So yeah, drugs are a must for me.

I thought this article was a little simplistic and pretty much common sense. The problem is, we're humans, with different body chemistries and health issues, not robots with standard-issue parts. I don't think there is one "right" answer in the supplements vs. drugs argument. If your cholesterol is 215 and you want to get it under 200, diet changes and a supplement may be enough to help. For someone whose cholesterol tops 400, a prescription drug may be their best chance of getting into a more suitable range.

Another problem is, too many people take supplements to cover up symptoms of what could be serious conditions. They don't visit their doctors and then they end up with serious problems that it may be too late to treat or cure. Or, people take supplements without knowing that they have a pre-existing condition, which can also be harmful. I, for example, have stage III kidney failure. Taking supplements would be a big mistake on my part, as it's a constant struggle to try to maintain calcium, phosphorus, sodium, and potassium levels in a patient with kidney disease. Adding even more of these to my diet with multivitamins would throw everything out of whack.

I don't think all supplements are inherently bad; just know where you are health-wise before taking them.

That being said, I'm on a buttload of drugs to control my high blood pressure. I dropped a bunch after a while from the first batch, which lasted awhile, then I ended up getting reformulated, adding minoxidil orally as a good drug to keep it down (I was definitely getting hairier while taking it!) until the rather bad and known side affect of water retention hit, despite two different diuretics. My nephrologist then found out my adrenal glands are twice the size of what they are supposed to be, pumping out twice the hormones they should be producing, and changing my drugs to combat that, which is still working. Drop something? I'm taking two diruetics, two different BP pills, a BP patch, and a few supplements, all just for my BP. The doctors just work to get a working cocktail for me. Everything is generic, except for the patch.

and, harkening back to an earlier consumerist story - my pharmacy jacked up the price of Levoxyl, so now I'm having to pay for it as a brand rather than as generic. Hello, Costco.

It's okay to advise caution - as many others did in this thread - but there's a line between 'addressing one or two points out of an article by crafting a reasoned response' and 'smearing the whole article and acting like a sanctimonious jerk'.

Makers of ADD meds are going to be soooooo screwed.

Not as much as the makers of penis pills.

Take thyroid meds for example. There's a reason why you need to stick with the name brand sometimes.

Makers of ADD meds are going to be soooooo screwed.

Open a carton of Sinus PE liquid gels from Walmart and another from Walgreens and look at the strips...They're made by the same company :P. Some drugs aren't yet OTC or Generic yet, but eventually it all happens. Omeprazole(Prilsec) is a helluva lot cheaper if you buy it OTC from your pharmacy than to get it prescribed or to buy the Prilosec 'brand'.

In this case, I think his approach was exactly the right one--make changes to the underlying problem, but use the tools available to help kickstart recovery.

(And, BTW, when I went from a 10mg dose to 5mg, I just got a pill splitter; the 10mg is only about 10% more than the 5mg.)

Yeah I know these prices are drastically less than what most of my friends pay for oral contraceptives, but I get great benefits through my mother who is a teacher.

@thelushie: drub=drug

Oh and I forgot about the doctor who my mom was seeing when her regular one went off somewhere for a year. My mom was having major gastric problems (including eggy burps and such). Well, she was asking about the surgeon who was going to do the colonoscopy. The doctor made the comment "You might as well set up as his patient. Whatever it is will have to come out surgically." Turns out her OB/GYN tested her for h.pylori (sp?) and she tested positive. After a shitload of medication, all the problems cleared up. Problem solved. When she told her regular doctor about this (who did come back from the great abyss), she chalked it up to a personality difference. Not a doctor making a stupid and irrational statement. Begs the question, though, how do you remove a bacteria surgically. It scares me what would have happened if she had not seen her Ob/GYN.

There are lots of snake oil salesmen and hippie new age nonsense around taking supplements but there are also some fairly straightforward companies and actual testing being done at universities and other credible sources. The problem is that the minute someone mentions supplements some people jump to the conclusion that it is snake oil or they were given or found bad information.

A good example (other than fish oil) is Bromelain. The FDA equivalent in Germany approved it for use as an anti-inflammatory. [www.umm.edu]

What a completely useless article. Wanna save money on drugs, don't buy em! Was this article written by captian obvious?

I can't wait for top twenty secret ways to prevent STDs!

@Gann: Yes, DOs are great! They see the body as a holistic system and not just a bunch of seperate organs to be brought into balance by whichever drub rep brought in the best donuts.

@Cerb: Hmmm, the ones I have seen are absolutely brillant and what is this about manipulation? That is a chiropractor (which, imo, is BS). I also find it funny that this comment is coming out of a supposed MD. Competition sucks in this day and age. Can't get into med school? Yeah right. Alot don't even try buy could have if the mood struck them. If I were to become a medical professional, I would take the DO route. I just can't be the type of person that is required to be an MD.

And before you say I just don't know as many of them. Yes I do. I socialize with the same type of people you do. I remember one doctor telling me about a med student who would kill small animals for fun. Short leap from small animals and people, isn't there? Most of the ones I know moan about only making $300,000 a year when Dr. Joe Shmoe makes $500,000.

And about the fish oil thing. It worked for me. I went off the statin and while the doctor (MD mind you) was lauding the benefits of the statin, I told him that it was making me a little ill and I went on fish oil. You should have seen the look on his face. Hilarious.

As a former health care worker, I remember all-too-well the patients letting the diet/exercise advice my boss would spend countless hours dispensing go in one ear and out the other - and how frustrated he would become over this.

Here's the problem with that theory: most of the "natural therapies" and "supplements" on the market are made and sold by exactly the same large, multinational pharmaceutical companies that bring you such classics as Vioxx and Olestra. Little research into those non-drug therapies is performed because a) it's cheaper, b) nobody's going to make them, and b) if the product is actually killing people, the pharma companies DON'T WANT TO KNOW.

@Gann:
"If you're going to talk to a doctor about natural ways to wean yourself off of meds, a doctor of osteopathic medicine would be more appropriate (talk to a D.O. instead of an M.D.) This kind of concept aligns perfectly with their training. "

Sorry, but most DO's go into osteopathy because they can't get into an MD program and then ignore osteopathy as soon as they go into practice. This isn't meant to disparage DOs, whome I think are generally fine doctors, but to dispel the notion that they really are any different than MDs in regards to practice.
I have a good number of DO friends and they all tell me the same thing, Osteopathic manipulation is a load of horse poo in most cases.

@thelushie:
"@Cerb: Most doctors want patients to eat well and exercise but the ones I have been to (and my mother has been to) don't want patients taking fish oil to lower cholestoral or any other type of natural remedy."
A lot of comments on drs not reccomending fish oil. That's probably because for a good deal of the pts we see, the lipid profiles are so unbelievable that fish oil would do very little by itself. Fish oil has been showed to reduce LDL, but no where near as well as statins like lipitor.

@SkokieGuy:
@Cerb: My rx for a pt complaining of sleep problems would depend on the circumstances. Sleep aids are not rec. for long term use. I would suggest they cut down their caffeine intake first and then we could try other things. I can't get too preachy here, I have had insomnia since I was a child and often have to take ambien.

As for supplements, a good deal of them are complete garbage. I will not rec. something based on folklore or because your herbalist/Navaho Spirit guide/etc says it cures ______. I will rec. it if there have been studies showing that it works (we frequently give pts chondroiten/Calcium supplements/etc). Aside from the lack of clinical trials regarding supplements, the fact that they are unregulated means there is a good chance the bioavailability of the supplement you are taking is close to zero.

@FLConsumer:
Well, I think a lot of those in private practice often fall into the "oooh new shiney drug" trap and prescribe the new drug (and a lot of times these drugs really are superior). Of course, there are many pts that demand the drug they just saw a commercial for. It comes down to good sense, which some doctors, for all their years of training, lack.

As for drug lunches being banned, they have been banned in many academic institutions around the country (which frankly I find insulting, I ahve never seen a drug rep present a new drug that didn't cause a lot of eye rolling). Private practice, which are generally the people rx'ing the $$ drugs, can of course continue to have drug lunches if they please

Most pharmaceutical companies have RX Assistance Programs for their medications. Check out the websites below. I think all of them have income guidelines but if you're low-income or without insurance they can be a big help. Usually you have to be referred by a social worker or advocate at your hospital or Dr.'s office, but you can get lots of name brand RX's for low or no cost.

[Social Worker]

www.rxassist.org
www.needymeds.com

Not so smart for time-released Rx, like anti-depressants.

We have both had very good success moving some of our prescriptions over to a supplement instead for certain conditions. We both were getting some awful side effects from a couple of prescriptions. What was the pcp doc's solution? Take more drugs to cover the side effects. We switched to supplements, lost the side effects and are doing better than on the prescriptions. I just wish more doctors would be open minded to this in some situations.

I also switched some of my meds to over the counter options that work as well or better.

I take 30mg of a particular drug. A 30-day supply of the 10mg and 20mg dosage is part of Walmart's $4.00 generics. The 30mg is not.

I do not have insurance so I was paying ~$60 dollars a month for the 30mg dosage.

When I found out about this I asked my doctor to write me a perscription for 10mg and 20mg. She happily obliged and now I pay only $8 a month for my prescription, saving $52 dollars in the process. :)

I do agree with you that we need to research options outside of Big Pharma. It's just that, partly because I live in California, I know an awful lot of people who think if it comes from a plant, it's harmless and not a drug. Also that what's on the label is informative and true.

@Cerb: You might have that mindset, but I can assure you that not every MD/DO in the field thinks the same. In medical clinics and hospitals I have worked in as well as Drs I've seen, physicians tend to prescribe the latest & greatest drugs while forgetting about their cheaper, older, and proven drugs which are now in generic form.

You say they're stopping the free lunches? I've not seen any slowdown of them. I did an experiment last year where I tried to see if I could eat a free lunch every single workday. I let the receptionist know my intentions (as well as brought her back plates) and I went a whole month without a problem. On many days I even had a choice of drug rep/caterers to choose from.

@PharmFatale: Absolutely awesome suggestion. Pharmacists spent a lot of time in school only to end up counting pills in most pharmacies. They're a very valuable and underutilized resource in the US.

Also, people should take a look at the warehouse clubs (Costco, etc.). No membership needed to use the pharmacies there and you'd be shocked at how much less their prices are. I transferred my parents' and grandmother's medications to Costco and in many cases Costco's price was actually less than what the insurance copay was at CVS.

200 / 8 = 25mg. You can see the idea I had. Now, I lose maybe 25mg to dust when I cut a pill down that small, but I'm still getting each pill for much, much less than I would otherwise. Of course, this med is just fine if you need an INEXACT dose. I'm fine if I take 35mg one day and 15 the next. If you're taking an antidepressant, an antibiotic or an anti-antipathy medication, or anything else that requires preciseitude, don't do this or split down to 50% at most. You can get a good pillcutter at any pharmacy for 10 bucks.

Remember, some meds are marked XR (extended release) or for some other reason can't be cut. These meds need their coating to be intact to work properly - usually they slowly release the med in your intestines over a longer period. Do NOT cut these. If your med has a groove down the middle to make splitting it easier, cut to your hearts content. Otherwise, ask your pharmacist.

This alone saves me ton every month.

@Cerb: Bravo to you and your practice. So when a patient comes in asking for (by name) Lunesta, do you recommend yoga or meditation first? Discuss their sleep hygiene? I mentioned not sleeping well to my (Blue Cross HMO) doctor and without a single question he wrote a Rx and gave me samples of two other drugs so I could experiement.

I can't tell you the number of doctors I've gone to who tell me supplements are a waste of money and will prescribe antibiotics at the drop of a hat, for crap like a cold to which antibiotics are at best, useless.

When my father came out of surgery for heart disease, the first meal he ate (ordered by the hospital dietician) was fried chicken, with mashed potatoes, gravy and jello.

@Cerb: Most doctors want patients to eat well and exercise but the ones I have been to (and my mother has been to) don't want patients taking fish oil to lower cholestoral or any other type of natural remedy.

@wiggatron: Yes, you can prevent disease naturally but, like medication and medicine in general, there are no sure things (or fixes). To help prevent AIDS, use a condom every time and don't fornicate with every willing person at the bar. Heart Disease: Exercise, watch what you eat, and take your fish oil. Etc. Etc. Sometimes a larger dose of a medicine is cheaper than a smaller dose, hence, split the pill.

Many manufacturers offer rebates on your out of pocket payment on non-generics (probably a way to stave off inevitable drug pricing reform). I'd recommend googling your drug name and "rebate" to see if yours are eligible.

Oh, and tell me what drug you can split and not effect the quality of?

A real tip that's not on there? Ask your physician to write you a 60 day supply as a 30 day supply (i.e., ask to write to take 1 twice a day, when you really only need to take it once a day) - You will get a 60 day supply for the same co-pay as a 30 day supply. Now that saves $$$!

Then again, I heard somewhere that pharmacists have issues splitting pills correctly all the time anyway, so to expect someone who has a pill cutter to do an accurate job is pretty out there.

Most of the article can be summarized: talk to your doctor and have them re-evaluate which pills are necessary, telling them if something is ineffective, have side effects, etc. And don't go for drugs as the first choice. There should be a manual on how to be a good patient.

@SkokieGuy:

"Most traditional doctors will discourage patients from pursuing non-drug options."

Bullshit. We would absolutely LOVE for our patients to eat right and exercise, it's just that it rarely happens. Contrary to what a lot of people believe, we really don't get kickbacks from the pharm industry (even pharm lunches have been taken away from most of us). Most of us prefer our patients to be on fewer drugs as studies show that increasing the number of drugs shows a positive correlation with a drug related incident.
As for the study regarding Vit E, don't believe the analysis of ANY study you hear about in the media. Most journalists haven't the slightest clue of how to separate good science from bad science and just choose the most sensationalistic option.

Always check the side effects. I was on Lipitor which was covered by my plan. One of the side effects is hair loss. I was also on Propecia which was not covered on my plan.

FWIW: I still have a goodly amount of hair on my head.

DO ask your doctor... if you know his prescribed medicine is not covered by your insurance, for example. I had a doctor that knee-jerk prescribed Cipro for every little infection. I asked her please to stop and give me something actually targeted for my infection and that my insurance would cover. She phoned a pharmacist, chatted for five minutes, and handed me a new prescription that worked better and was absurdly inexpensive.

Most traditional doctors will discourage patients from pursuing non-drug options.

Many studies (funded by major drug companies) discount the benefits of suplements and alternative care. These studies are promoted to the medical community to arm them to fight patient's attempt to find non-drug paths to health.

CBS headline "Vitamin E May Shorten Life".

Pretty scary and pretty convincing and blared throughout the traditional media who has a vested interest in not angering the drug company who spend a fortune on advertising.

What is not well publicized is that the study may well be total bullshit.

The author of the study, in the Journal of the American Medical Association (JAMA), concede that the "unexpected results cannot be confirmed at this time by other trials" and "could be due to chance."
[nutrition.about.com]

With the consolidation of media, it is impossible to get accurate health news and alternative medicine often does not result in a patentable treatment (asthma? drink more water) - so little research into non-drug therapies is performed.

One way out of our healthcare crisis is for our government to fund research into alternative treatments.

You could always grow your own and save BIG bucks...